Crescent Moon Recovery, Llc
LBN: Crescent Moon Recovery, Llc
Crescent Moon Recovery, Llc is an health care organization with primary practice located at 18652 Florida St Suite 200, Huntington Beach CA 92648-6000. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder, which is considered as the primary health care specialty.
Crescent Moon Recovery, Llc can be contacted via phone (714) 464-8474, or through Wade, Adam via phone (661) 706-8898.
Contact Information
Primary practice address
18652 Florida St Suite 200
Huntington Beach CA 92648-6000
Phone: (714) 464-8474
Fax: (714) 948-8883
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder | 261QR0405X |
Profile Details
| NPI number | 1497414379 |
|---|---|
| LBN Legal business name | Crescent Moon Recovery, Llc |
| DBA Doing business as | |
| Authorized official | Wade, Adam Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 8th, 2021 |
| Last updated | Apr 30th, 2024 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497414379 | NPPES |
| California | Other | CLR-90002425 | CDPH CLIA LICENSE, STATE ID |
| California | Other | 300398AP | CDPH CLIA LICENSE, STATE ID |
| California | Other | 661764 | CDPH CLIA LICENSE, STATE ID |
| California | Other | 05D2207074 | CDPH CLIA LICENSE, STATE ID |
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